During a surgical procedure the patient is anesthetized and is unable to either voice complaints of pain or to move his or her extremities in response to pain stimulus. Consequently, the responsibility of positioning the patient so as to avoid injuries to the patient's body outside of the operative area is the responsibility of the operating room personnel. More particularly, procedures done on the central part of a patient's body, including the head and neck, require that operating room personnel be in close proximity to a patient's body for extended periods of time. During these periods of time a patient's arm is simply in the way. For example, during a laparoscopic procedure surgeons are positioned close to a patient's side and high enough on a patient's torso so that a patient's arm cannot be placed on an arm rest perpendicular to the body. This could stretch the arm too much and possibly cause a brachial nerve injury. In order to position a patient's arm in these types of procedures, a number of expedients can be employed. Ad hoc equipment is sometimes used, such as a cardboard box, which may be used to support a patient's hand. The patient's arm and hand can be tucked and held in place by folding the surgical drape or other covering which may be placed underneath the patient, which then holds the patient's arm in place along the patient's body.
A currently marketed product that is used to hold a patient's arm in place is sometimes called a sled or toboggan because of its resemblance to the item of the same name. One such item is marketed by a company called AliMed™ and is called a toboggan arm/leg guard. This is a hard plastic shell or sled. A portion of the sled slides under the operating room mattress, which is positioned on the operating room table. However, it can be difficult to position the portion of the sled that slides under the mattress because the operating table mattress is ordinarily attached in place onto the operating room table by a hook-and-eye attachment known by the trade name Velcro™. This Velcro™ forms a barrier to sliding the support portion of the sled under the mattress. The sled is made of hard material and the patient's arm, when positioned inside the sled, must be cushioned in some way. This protective device also makes it difficult to check IV and arterial line sites in the patient's hands or arms during a procedure. Moreover, because it is used from procedure to procedure, it can raise issues regarding the sterile field necessary during an operating room procedure. Unless made of appropriate materials, the sled may not be radiolucent, hence may make taking x-rays during the course of procedures more difficult.
A variation of the sled or toboggan is seen in Fischer, U.S. Pat. No. 5,785,057. This invention includes an elongated rigid shell with an end cap for enclosing one of the hands and fingers. A base portion is slid under the mattress to hold the sled in place. Tari, U.S. Pat. No. 4,662,366, discloses a radiolucent mobilizing arm support. This is designed primarily to secure a patient's arm during certain procedures, especially heart procedures, which require ongoing radiographic images, such as angioplasty. Consequently, the Tari patent uses a strap system which wraps completely around the operating room table, including the patient's torso, and a separate hand-securing strap portion which is secured to the patient's lower torso. The Tan device is inappropriate for use in most surgical procedures. However, the Tri patent does illustrate the desirability of a radiolucent securing device for a patient's arm. Longfellow, U.S. Pat. No. 2,237,252, discloses a rigid arm support for a patient's arm and includes two soft pads that support one for the upper arm and one for the lower arm. Straps are used to secure the patient's arm to the support. The support itself rests on a pivoting piece, which may rest either under the patient or under the operating table mattress. It is for use when the patient is in the supine position and the arm may need to be immobilized for extended periods.
Despite this earlier work, there is still a need for a simple, inexpensive, and easy to use device which will secure a patient's arms and protect them from injury from outside forces. It will be used during the course of procedures where the patient is in the prone or supine position. Sometimes a surgeon may be working in proximity to the patient's torso. This device can be made disposable, so that there will be no need to sterilize the device from use to use, thus to reduce the risk of contamination to the sterility of the operative field. This device should be easily and quickly removable from an extremity of a patient. When it is quickly and easily removable from an extremity of a patient, it facilitates the ability to reposition a patient during a procedure. The device should be flexible, so that a portion of it may be folded out of the way to visualize a patient's arm during a procedure. The device should be easily cut or torn by standard cutting devices, such as scissors, so that portions may be removed if necessary to provide continuous visualization of that portion of the patient's body which would otherwise be concealed under the device during use.